Provider Demographics
NPI:1891189254
Name:SWIFT, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SWIFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ARMSTRONG RD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-2709
Mailing Address - Country:US
Mailing Address - Phone:860-803-3121
Mailing Address - Fax:
Practice Address - Street 1:28 CENTRE DR
Practice Address - Street 2:MAILSTOP 416SA1
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468
Practice Address - Country:US
Practice Address - Phone:802-847-2700
Practice Address - Fax:802-847-0386
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VT042.0014174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program